Getting ready for the FRCEM OSCE might feel overwhelming, especially if you don't have a clear picture of how the examination day will unfold. Unlike the FRCEM SBA, which features a written component, the OSCE focuses on practising skills. It is different from the FRCEM SBA, which is written and knowledge-based, as the OSCE attempts to measure your skills in real-life scenarios of emergency medicine.
In this blog, we will focus on FRCEM OSCE’s format, observable skills, and grading criteria so that you can know how to prepare best.

What is the FRCEM OSCE?

The FRCEM OSCE is a practical examination that aims to replicate the experience of working in an emergency department (ED). The examination is divided into multiple stations for a given and set amount of time, and for each station, there is an actor, an examiner, and various other emergency department tools and equipment.

Your goal is to demonstrate that you are capable of managing observed emergency cases in a safe, calibrated, and professional manner.

As per the Royal College of Emergency Medicine, OSCE examinations test the following competencies:

  • Implementing clinical knowledge
  • Practical skills and procedures
  • Interpersonal skills and collaboration
  • Professional conduct and safety concerning the patient

(Source: RCEM Exams)

Structure of the Examination

  • Total Number of Stations: There is no fixed total number of stations for all OSCE exams; the ideal number is a balance between comprehensiveness and practicality. 
  • Duration for Each Station: Approximately 7 to 10 minutes
  • Rotation: You’ll progress from one station to the next in a fixed order with brief pauses in between

Each station has a specific task, and you’ll need to focus on

Types of OSCE Stations

OSCE is structured to assess a broad range of emergency medicine skills. The following are the most frequent station types:

1. History & Examination

  • Take a directed history from a patient presenting with chest pain, shortness of breath, or abdominal pain
  • Conduct an appropriate physical examination
  • Present your findings to the examiner

2. Clinical Procedures

  • Demonstrating management of the airway
  • Placing a chest drain
  • Wound suturing
  • Operating defibrillation equipment

3. Communication Skills

  • Breaking bad news
  • Elucidating a diagnosis or treatment plan
  • Gaining informed consent for an unsafe procedure
  • Managing an angry relative

4. Emergency Management

  • Managing a cardiac arrest
  • Trauma resuscitation (ABCDE approach)
  • Treating a paediatric emergency
  • Prioritising critically ill patients

5. Teamwork & Prioritisation

  • Leading a resuscitation team
  • Delegating tasks appropriately
  • Managing multiple ED patients simultaneously

The stresses of real-life emergency medicine underpin these stations. The examiners are looking to see that you remain calm, think logically, and have patient safety uppermost in your mind.

How the OSCE is Marked

Understanding how the OSCE is assessed helps you prepare. The marking process in the FRCEM OSCE is both organized and fair.

First up, there's the Checklist System: Each station has specific actions you need to complete, checking vital signs, and explaining risks. Completing these actions earns you marks.

Then we have the Global Rating Scale: Examiners provide an overall assessment of your performance, taking into account your professionalism, confidence, and safety.

Next is the Borderline Regression Method: The pass mark is determined statistically based on how examiners score all candidates, so that it might shift a bit from one exam to the next.

Finally, the Overall Pass Requirement: You don’t have to ace every station — as long as your average score across all stations is above the pass mark, you’re good to go.

So, even if you find a couple of stations challenging, you can still pass overall if you shine in other areas!

How to Prepare for the OSCE.

Here are some helpful tips to boost your confidence as you prepare:

Practice Common Scenarios

  • Go through airway management, trauma calls, and typical emergency department cases.
  • Join study groups to role-play history-taking and communication exercises.

Refine Your Procedures

  • Get hands-on experience with equipment like airways, defibrillators, and chest drains.
  • Practice suturing and IV access techniques on models whenever you can.

Work on Communication

  • Effective and empathetic communication is crucial.
  • Practice breaking down complex procedures into simple terms.

Time Management

  • Each station is brief—focus on the main priorities rather than getting lost in every detail.

Stay Calm Under Pressure

  • Remember, the examiners aren’t there to trip you up; they want to see if you can handle the situation safely.
  • Organize your responses: use ABCDE for emergencies and SBAR for communication.

Useful Resources:

Here are some useful resources where you can learn and practice more:
Royal College of emergency medicine
BMC Medical Education
Neethu's Academy

Conclusion: 

The FRCEM OSCE can seem intimidating, but once you understand the format, stations, and marking system, it becomes much more approachable.
Remember: the OSCE is not about being perfect , it’s about proving you are safe, competent, and professional in an emergency setting.
And if you’re still preparing for the FRCEM SBA, don’t forget — the SBA is your stepping stone before the OSCE.
Check out our FRCEM SBA question bank at StudyFRCEM.com to strengthen your knowledge base before moving on to OSCE practice.